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Breast milk jaundice — USMLE Step 3 MCQ

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ModeratePediatrics (well-child, chronic management)Breast milk jaundiceUSMLE Step 3

A 14-day-old term infant has persistent jaundice. He is breastfeeding well, gaining weight, and has normal stools and urine. Total bilirubin is 11 mg/dL with direct bilirubin 0.4 mg/dL. Examination is otherwise normal. Which of the following is the most likely explanation for this patient's findings?

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Correct answer: E — Unconjugated hyperbilirubinemia associated with breastfeeding

Breast milk jaundice causes benign unconjugated hyperbilirubinemia in a thriving breastfed infant; conjugated bilirubin elevation or pale stools requires urgent evaluation.

Reference: AAP hyperbilirubinemia guideline